Good dental care for kids should start early

Caring for your baby’s teeth — as soon as the first one appears — will go a long way to keeping your child healthy.

Started early, good dental care practices help children get used to having a toothbrush and floss in their mouths, said pediatric dentist Dr. Chad Hoge, who practices at Dakota Pediatric Dentistry in Grand Forks, N.D.

They also help counteract the damage that sugar can do to kids’ teeth.

“Children are typically exposed to sugary foods and sugary drinks early on,” he said. “Diet and oral hygiene at home are the biggest factors” in preventing dental problems down the road.

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The marketplace is full of dental care products created especially for kids, “like a toothbrush with Shrek on it,” he said, “anything to make it more fun.”

Usually, the first tooth appears at 7 or 8 months, he said, “most often it’s the front incisor on the bottom, although some develop earlier and some later.”

Parents who aren’t comfortable putting a toothbrush in their baby’s mouth could instead use a rubber fingertip device to clean teeth.

“There’s so much to choose from now,” he said.

Depending on how the child is taking to brushing, “at about age 3 years, you can let them do a little bit of brushing on their own,” he said. “But we want the parent to go in afterwards and go over it again” to ensure that the job is done thoroughly.

“At that age, kids don’t have the dexterity to brush properly, especially on the back teeth.”

Children aren’t able to brush their teeth well until age 9, he said.

He doesn’t recommend that children use any type of mouthwash until they are older than 6. Until then, “they may not be able to swish everything out,” he said.

To best help a child learn good habits of dental care depends on the parents’ determination to establish a routine, he said.

“We have a 3-year-old, and it’s a challenge for us sometimes. Not every night are they going to want to brush their teeth.”

To convey the importance of a routine, he said. “We say, ‘This is what we do: we get up, we eat breakfast, we brush our teeth. And at night, before bed, we brush our teeth.’”

EARLY DENTAL VISIT

Sometimes, parents wait until the child is 3 or 4, he said, “but by then (the child) could have a problem, and we could have prevented it … We want parents to understand that it’s good to bring a child in early.”

Hoge suggests that parents schedule a child’s first dental visit at 12 months old, following the American Academy of Pediatric Dentists and the American Academy of Pediatrics recommendations.

“Typically, we start seeing kids at 1 year old,” he said. “Parents come in with questions.”

Many “don’t know how often we need to brush teeth and start flossing,” he said.

The first visit “is a short appointment – more of an educational visit,” he said. Under age 3, “a kid has trouble sitting in a chair too long.”

A dental exam can be stressful for children, he said.

“For a child to cry a little bit in the chair is OK; we’re equipped to deal with it.”

He and other dentists in the clinic teach parents how to brush their children’s teeth, using a “knee-to-knee” examination in which the dentist and parent face each other, knees to knees, with the child facing the parent and leaning his head back to the dentist.

The technique can be replicated at home, between parents, or by laying the child on a flat surface.

COMFORT LEVEL

Dental visits earlier in life increase the child’s comfort level with the dentist and make future visits easier, especially when their cooperation and ability to sit still are necessary, Hoge said.

Early visits also give dentists a chance “to talk to parents about changes we’d like to see in the habits being formed at home,” he said, among them, putting a child to bed with a bottle of milk or juice.

At bedtime, after teeth-brushing and -cleaning, children “should stick with water,” he said, “and avoid snacking.”

“We focus on the parents because (they) are going to be the biggest factor” in the child’s dental health.

He encourages parents to limit snacks to no more than three times a day and to not let children “drink juice throughout the day,” he said. “Don’t have your child walk around with a cup of juice.

“If they do drink it, it should only be during meals.”

A lot of his younger patients “are taking in juice and stickier foods, like gummy bears and fruit roll-ups,” Hoge said. These foods “usually have sugar and acids in them that cause damage to the teeth.

“If (parents) are not comfortable getting in there with brushing, the (food) sits there forever. It could be 6 or 7 hours before brushing (is done) at bedtime.”

These habits could result in tooth decay, he said.

“Cavities can appear in the front or back baby molars. It has a lot to do with diet and how they’re brushing and flossing at home.”

Hoge and his colleagues “promote flossing, especially for kids with teeth that are close together, but we recommend it for everyone.”

For parents “to play around with flossing, it’s more for the (child’s) comfort level than anything.”

Left untreated, “a cavity can enlarge and cause discomfort,” and cause the child to miss school or have trouble sleeping, he said. Or worse, “it can cause an abscess or an infection.”

Whether or not to fill a cavity in a baby tooth “depends on the age of the child,” Hoge said. “A 3-year-old child with a cavity in a back baby molar will need that tooth for another 7 to 9 years.

“We may decide to fill it because (the child) needs it for so long.”

In rare instances, children could experience tooth defects, such as the enamel not being formed properly, he said. In such cases, it’s usually due to timing.

“The child being ill or taking antibiotics at the wrong times (in his or her development) can form defects.”

He and his colleagues “treat every child on an individual basis,” he said. “Every child is so different.”

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